Individual
MARA ENDOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1501 S CALIFORNIA AVE, CHICAGO, IL 60608-1732
(773) 257-6770
Mailing address
1501 S CALIFORNIA AVE, CHICAGO, IL 60608-1732
(773) 257-6770
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
209-004922
IL
363LA2200X
Adult Health Nurse Practitioner
Primary
209004922
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209-004922
APN LICENSE
IL
Enumeration date
05/17/2006
Last updated
03/18/2025
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